It is thought to be involved in producing pleasurable feeling and is often associated with feelings of reward and desire, particularly because of the connection to the nucleus accumbens which has also been associated with these states. Because of this, this pathway is heavily implicated in neurobiological theories of addiction.

The mesolimbic pathway is one of the major pathways targeted by antipsychotic medication. Although poorly understood, disruption to dopamine function (particularly, an excess of dopamine) in this area has been linked to psychosis and the 'positive symptoms' of schizophrenia (particularly delusions and hallucinations). Successful antipsychotic medication is therefore thought to have its effect by blocking dopamine receptors in this pathway.